Contribution of Obstructive Sleep Apnoea to Cognitive Functioning of Males With Coronary Artery Disease: A Relationship With Endocrine and Inflammatory Biomarkers

Overview

Journal Front Neurosci

Date 2022 Aug 4

PMID 35924228

Authors

Nijole Kazukauskiene

Naomi A Fineberg

Aurelija Podlipskyte

Adomas Bunevicius

Nicolas Francisco Narvaez Linares

Marilou Poitras

Helene Plamondon

Aiste Pranckeviciene

Julija Gecaite-Stonciene

Narseta Mickuviene

Giedrius Varoneckas

Julius Burkauskas

Affiliations

Soon will be listed here.

Abstract

Introduction: Our exploratory study aimed to determine whether obstructive sleep apnoea (OSA) could affect cognitive functioning in males with coronary artery disease (CAD), and whether such impact could be associated with changes in thyroid hormones and inflammatory marker regulation on cognitive functioning.

Method: We evaluated different endocrine and inflammatory biomarkers, including free triiodothyronine [fT3], free tetraiodothyronine [fT4], N-terminal pro-B-type natriuretic peptide [NT-pro-BNP], and high-sensitivity C-reactive protein [hs-CRP] serum levels in 328 males ( = 57 ± 10 years), undergoing cardiac rehabilitation after an acute coronary event. Participants underwent full-night polysomnography and were classified in mild/non-OSA ( = 253) and OSA ( = 75) according to an apnoea-hypopnoea index ≥ 15 event/h. Cognitive functioning testing included the Digit Span Test, Digit Symbol Test (DSST), and Trail Making Test. Analyses of variance assessed the impact of OSA on cognitive functioning and possible relationships of fT3/fT4, NT-pro-BNP and with hs-CRP on cognitive measures.

Results: Significant group (OSA, mild/non-OSA) × NT-pro-BNP (<157.0 vs. ≥157.0, ng/L) interactions were found for the DSST raw score ( = 3.58, = 0.014). Decomposition of interactions showed that the DSST scores of the OSA group with NT-pro-BNP ≥ 157.0 ng/L ( = 33.2; SD = 8.1) were significantly lower, = 0.031, than those of the mild/non-OSA with NT-pro-BNP < 157.0 ng/L ( = 37.7; SD = 8.9).

Conclusion: These findings indicate that males with OSA and clinically elevated NT-pro-BNP levels experienced inferior psychomotor performance compared to those without OSA and reduced NT-pro-BNP levels.

Citing Articles

Role of sleep disorders in patients with cardiovascular disease: A systematic review.

Zhang L, Li G, Bao Y, Liu M Int J Cardiol Cardiovasc Risk Prev. 2024; 21:200257.

PMID: 38549735 PMC: 10972826. DOI: 10.1016/j.ijcrp.2024.200257.

References

Yu F, Yuan C, Tong J, Zhang G, Zhou F, Yang F . Protective effect of sphingosine-1-phosphate for chronic intermittent hypoxia-induced endothelial cell injury. Biochem Biophys Res Commun. 2018; 498(4):1016-1021. DOI: 10.1016/j.bbrc.2018.03.106. View

Bonsignore M, Borel A, Machan E, Grunstein R . Sleep apnoea and metabolic dysfunction. Eur Respir Rev. 2013; 22(129):353-64. PMC: 9487354. DOI: 10.1183/09059180.00003413. View

Marin J, Carrizo S, Vicente E, Agusti A . Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet. 2005; 365(9464):1046-53. DOI: 10.1016/S0140-6736(05)71141-7. View

Barletta P, Abreu A, Ramos A, Dib S, Torre C, Chediak A . Role of Obstructive Sleep Apnea in Cognitive Impairment. Int J Head Neck Surg. 2021; 10(3):57-61. PMC: 8302067. DOI: 10.5005/jp-journals-10001-1373. View

Zhang X, Gao B, Han T, Xiang B, Liu X . Moderate-to-Severe Obstructive Sleep Apnea and Cognitive Function Impairment in Patients with COPD. Int J Chron Obstruct Pulmon Dis. 2020; 15:1813-1822. PMC: 7396955. DOI: 10.2147/COPD.S257796. View

Bunevicius R, Kazanavicius G, Zalinkevicius R, Prange Jr A . Effects of thyroxine as compared with thyroxine plus triiodothyronine in patients with hypothyroidism. N Engl J Med. 1999; 340(6):424-9. DOI: 10.1056/NEJM199902113400603. View

Balady G, Bricker J, Chaitman B, Fletcher G, Froelicher V, Mark D . ACC/AHA 2002 guideline update for exercise testing: summary article. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). J Am Coll Cardiol. 2002; 40(8):1531-40. DOI: 10.1016/s0735-1097(02)02164-2. View

Lindberg E, Benediktsdottir B, Franklin K, Holm M, Johannessen A, Jogi R . Women with symptoms of sleep-disordered breathing are less likely to be diagnosed and treated for sleep apnea than men. Sleep Med. 2017; 35:17-22. DOI: 10.1016/j.sleep.2017.02.032. View

Burkauskas J, Bunevicius A, Brozaitiene J, Neverauskas J, Lang P, Duwors R . Cognitive Functioning in Coronary Artery Disease Patients: Associations with Thyroid Hormones, N-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein. Arch Clin Neuropsychol. 2017; 32(2):245-251. DOI: 10.1093/arclin/acx004. View

10.

Huang Y, Guilleminault C, Hwang F, Cheng C, Lin C, Li H . Inflammatory cytokines in pediatric obstructive sleep apnea. Medicine (Baltimore). 2016; 95(41):e4944. PMC: 5072934. DOI: 10.1097/MD.0000000000004944. View

11.

Bubu O, Andrade A, Umasabor-Bubu O, Hogan M, Turner A, de Leon M . Obstructive sleep apnea, cognition and Alzheimer's disease: A systematic review integrating three decades of multidisciplinary research. Sleep Med Rev. 2019; 50:101250. PMC: 7593825. DOI: 10.1016/j.smrv.2019.101250. View

12.

Cifci N, Uyar M, Elbek O, Suyur H, Ekinci E . Impact of CPAP treatment on cardiac biomarkers and pro-BNP in obstructive sleep apnea syndrome. Sleep Breath. 2009; 14(3):241-4. DOI: 10.1007/s11325-009-0306-y. View

13.

Irwin M, Olmstead R, Carroll J . Sleep Disturbance, Sleep Duration, and Inflammation: A Systematic Review and Meta-Analysis of Cohort Studies and Experimental Sleep Deprivation. Biol Psychiatry. 2015; 80(1):40-52. PMC: 4666828. DOI: 10.1016/j.biopsych.2015.05.014. View

14.

Seda G, Han T . Effect of Obstructive Sleep Apnea on Neurocognitive Performance. Sleep Med Clin. 2020; 15(1):77-85. DOI: 10.1016/j.jsmc.2019.10.001. View

15.

Burkauskas J, Bunevicius A, Brozaitiene J, Neverauskas J, Fineberg N, Wellsted D . Exploring Cognitive Concomitants of Mental Fatigue in Patients with Coronary Artery Disease. Neuropsychobiology. 2018; 76(3):151-160. DOI: 10.1159/000489713. View

16.

Lavrentaki A, Ali A, Cooper B, Tahrani A . MECHANISMS OF ENDOCRINOLOGY: Mechanisms of disease: the endocrinology of obstructive sleep apnoea. Eur J Endocrinol. 2018; 180(3):R91-R125. DOI: 10.1530/EJE-18-0411. View

17.

Joy S, Fein D, Kaplan E, Freedman M . Speed and memory in WAIS-R-NI Digit Symbol performance among healthy older adults. J Int Neuropsychol Soc. 2000; 6(7):770-80. DOI: 10.1017/s1355617700677044. View

18.

Hachinski V, Iadecola C, Petersen R, Breteler M, Nyenhuis D, Black S . National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006; 37(9):2220-41. DOI: 10.1161/01.STR.0000237236.88823.47. View

19.

Kumar S, Anton A, DAmbrosio C . Sex Differences in Obstructive Sleep Apnea. Clin Chest Med. 2021; 42(3):417-425. DOI: 10.1016/j.ccm.2021.04.004. View

20.

Tishler P, Larkin E, Schluchter M, Redline S . Incidence of sleep-disordered breathing in an urban adult population: the relative importance of risk factors in the development of sleep-disordered breathing. JAMA. 2003; 289(17):2230-7. DOI: 10.1001/jama.289.17.2230. View